<!-- INCLUDE overall_header.html -->



<script type="text/javascript">

<!--

	/**

	* Change language

	*/

	function change_language(lang_iso)

	{

		document.forms['register'].change_lang.value = lang_iso;

		document.forms['register'].submit.click();

	}

//-->

</script>



<form name="register" method="post" action="{S_UCP_ACTION}">



<table class="tablebg" width="100%" cellspacing="1">

<tr>

	<th colspan="2" valign="middle">{L_REGISTRATION}</th>

</tr>



<!-- IF ERROR -->

	<tr>

		<td class="row3" colspan="2" align="center"><span class="gensmall" style="color:red">{ERROR}</td>

	</tr>

<!-- ENDIF -->



<!-- IF L_REG_COND -->

	<tr> 

		<td class="row2" colspan="2"><span class="gensmall">{L_REG_COND}</span></td>

	</tr>

<!-- ENDIF -->

<!-- IF .profile_fields -->

	<tr> 

		<td class="row2" colspan="2"><span class="gensmall">{L_ITEMS_REQUIRED}</span></td>

	</tr>

<!-- ENDIF -->



<tr>

	<td class="row1" width="38%"><b class="genmed">{L_USERNAME}: </b><br /><span class="gensmall">{L_USERNAME_EXPLAIN}</span></td>

	<td class="row2"><input class="post" type="text" name="username" size="25" maxlength="40" value="{USERNAME}" /></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_EMAIL_ADDRESS}: </b></td>

	<td class="row2"><input class="post" type="text" name="email" size="25" maxlength="255" value="{EMAIL}" /></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_CONFIRM_EMAIL}: </b></td>

	<td class="row2"><input class="post" type="text" name="email_confirm" size="25" maxlength="255" value="{EMAIL_CONFIRM}" /></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_PASSWORD}: </b><br /><span class="gensmall">{L_PASSWORD_EXPLAIN}</span></td>

	<td class="row2"><input class="post" type="password" name="new_password" size="25" maxlength="100" value="{PASSWORD}" /></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_CONFIRM_PASSWORD}: </b></td>

	<td class="row2"><input class="post" type="password" name="password_confirm" size="25" maxlength="100" value="{PASSWORD_CONFIRM}" /></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_LANGUAGE}: </b></td>

	<td class="row2"><select name="lang" onchange="change_language(this.value); return false;">{S_LANG_OPTIONS}</select></td>

</tr>

<tr>

	<td class="row1"><b class="genmed">{L_TIMEZONE}: </b></td>

	<td class="row2"><select name="tz">{S_TZ_OPTIONS}</select></td>

</tr>

<!-- BEGIN profile_fields -->

	<tr>

		<td class="row1" width="35%">

			<b class="genmed">{profile_fields.LANG_NAME}: </b>

			<!-- IF profile_fields.S_REQUIRED --><b>*</b><!-- ENDIF -->

			<!-- IF profile_fields.LANG_EXPLAIN --><br /><span class="gensmall">{profile_fields.LANG_EXPLAIN}</span><!-- ENDIF -->

		</td>

		<td class="row2">{profile_fields.FIELD}<!-- IF profile_fields.ERROR --><br /><span class="gensmall" style="color:red">{profile_fields.ERROR}</span><!-- ENDIF --></td>

	</tr>

<!-- END profile_fields -->



<!-- IF S_CONFIRM_CODE -->

	<tr>

		<th colspan="2" valign="middle">{L_CONFIRMATION}</th>

	</tr>

	<tr>

		<td class="row3" colspan="2"><span class="gensmall">{L_CONFIRM_EXPLAIN}</span></td>

	</tr>

	<tr>

		<td class="row1" colspan="2" align="center">{CONFIRM_IMG}</td>

	</tr>

	<tr>

		<td class="row1"><b class="genmed">{L_CONFIRM_CODE}: </b><br /><span class="gensmall">{L_CONFIRM_CODE_EXPLAIN}</span></td>

		<td class="row2"><input class="post" type="text" name="confirm_code" size="8" maxlength="8" /></td>

	</tr>

<!-- ENDIF -->



<!-- IF S_COPPA -->

	<tr>

		<th colspan="2" valign="middle">{L_COPPA_COMPLIANCE}</th>

	</tr>

	<tr>

		<td class="row3" colspan="2"><span class="gensmall">{L_COPPA_EXPLAIN}</span></td>

	</tr>

<!-- ENDIF -->



<tr>

	<td class="cat" colspan="2" align="center">{S_HIDDEN_FIELDS}<input class="btnmain" type="submit" name="submit" value="{L_SUBMIT}" />&nbsp;&nbsp;<input class="btnlite" type="reset" value="{L_RESET}" name="reset" /></td>

</tr>

</table>



{S_FORM_TOKEN}</form>



<!-- INCLUDE overall_footer.html -->